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January 19, 2021

Many Black and Hispanic Americans lack confidence in access to COVID-19 vaccines, treatments

A new analysis shows racial divides in perceptions of health care access, underscoring a mistrust rooted in structural racism

The COVID-19 pandemic has magnified racial health care disparities and the mistrust that many people of color have toward the health care industry. 

Black and Hispanic Americans are almost twice as likely as white Americans to say their access to COVID-19 vaccines, treatments and health care is worse than other racial and ethnic groups, according to a new Quest Diagnostics Health Trends analysis.

There are reasons for their skepticism: Black Americans, along with Hispanic and Native Americans, are dying from COVID-19 at almost triple the rate of white Americans. And the coronavirus vaccine rollout also has revealed inequities. 

Black Americans are receiving COVID-19 vaccines at significantly lower rates than white Americans, according to a Kaiser Health News analysis

The 16 states that have released racial breakdowns indicate that the vaccination rate of white Americans is two or three times higher. Nowhere is that disparity greater than in Pennsylvania, where 1.2% of white residents have been vaccinated compared to 0.3% of Black residents. 

Overall, about 3% of Americans had received at least one vaccine dose through Thursday. 

At this point, vaccines primarily have been given to health care workers — a diverse group that encompasses physicians to hospital custodians. If the vaccine rollout is reaching all demographics equally, the vaccination data should mirror the industry's demographic breakdown, the KHN analysis suggests. But it does not. 

Instead, access issues and a mistrust stemming from structural racism appear to be the major reasons for the disparity. The Quest analysis underscores the element of mistrust. 

The analysis, based on a nationally representative survey conducted online by The Harris Poll, found that more Black and Hispanic residents believe their access to COVID-19 testing, therapeutics, quality preventative care and quality COVID-19 care is inferior to the access given to people of other races.

Overall, 84% of white Americans reported being confident they would receive the same life-saving care as people of other races or ethnicities. But only 67% of Hispanic Americans and 64% of Black Americans shared that confidence.

Black and Hispanic people also are less likely to believe their doctor will do everything possible to save their lives if diagnosed with COVID-19, the survey found.

One in two Black residents surveyed were concerned they have an undiagnosed health condition compared with 39% of white residents. The data also showed that a larger percentage of Hispanic Americans delayed medical care during the pandemic than white and Black Americans.

"COVID-19 has exacerbated longstanding inequities in health care particularly among communities of color. Our new Health Trends research reveals people perceive, trust and engage with the health care system for COVID-19 differently depending on race and ethnicity," said Harvey W. Kaufman, senior medical director and head of the Health Trend Research Programs for Quest Diagnostic.

"Importantly, it also reveals they expect America's COVID-19 experience will lead to meaningful change in health care. Policy makers and providers should take these insights to heart, particularly as our country embarks on an unprecedented vaccine program."

A little more than half of all the Americans surveyed said they expect racial disparities in health care to be addressed in the wake of the COVID-19 pandemic. But for this to happen, the damage caused by structural racism and unethical medical research practices — like the Tuskegee study — needs to be recognized, experts say.

The Tuskegee study was a 40-year project studying syphilis in Black males that was conducted without patients' informed consent and without providing proper treatment for the participants. While this study is probably the most referenced example of medical experimentation on Black Americans, it is not the only one.

Unethical medical experimentation on Blacks began during the colonial times and continued into the 20th century. This medical abuse, along with current disparities in access to medical care, continue to be at the root of people of color's mistrust in the U.S. health care system.

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